The Nottwil Standard-Development and Implementation of an International Classification of Functioning, Disability and Health-Based Clinical Standard Assessment for Post-acute Rehabilitation After Newly Acquired Spinal Cord Injury.

The study was conducted in a single specialized clinic, so results may not generalize to other settings. The hospital information system did not have automated reminders for all assessments during the pilot, which may have contributed to the low compliance rates for pain, autonomic, and mental health tools. Validated assessment tools were not available for seven ICF categories (e.g., intimate relationships, handling stress), leaving these areas of functioning undocumented by standardized measures. This is an implementation study of an assessment standard, not a clinical trial; it reports on process compliance, not patient outcomes or the effectiveness of the assessments themselves.

The authors declared no commercial or financial conflicts of interest. The handling editor declared a past collaboration with two of the authors.

Do not interpret the high compliance with physical tests as evidence that the entire standard is being followed. Assessments for autonomic function, pain, and mental health were missed in over half of the patients, indicating that a comprehensive ICF-based assessment is difficult to achieve without automated system support.